复发性喘息婴幼儿呼出气一氧化氮的诊断价值研究

Diagnostic value study of fractional exhaled nitric oxide(FeNO) in infants with recurrent wheezing

目的研究呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)与哮喘预测指数(asthma predictive index,API)、血嗜酸性粒细胞(blood eosinophil count,EOS)计数、喘息次数的相关性。方法选取2015年2月至2016年8月于北部战区总医院儿科门诊就诊及住院的年龄≤3岁的复发性喘息患儿101例为研究对象,依据API评分表将患儿分为API阳性组(n=55)和API阴性组(n=46),根据喘息次数将患儿分为喘息3~4次组和≥5次组,选择同期健康儿童37例为对照组,对所有儿童行FeNO浓度检测、完善血常规行EOS计数。结果(1)API阳性组患儿FeNO均值(19.3±6.2)ppb明显高于API阴性组(7.7±2.9)ppb,差异有统计学意义(P<0.01)。API阴性组患儿FeNO均值(7.7±2.9)ppb略低于正常对照组(9.5±2.0)ppb,差异无统计学意义(P>0.05)。(2)API阳性组患儿EOS计数均值为(124.7±1.6)×10^6/L,高于API阴性组(86.1±1.9)×10^6/L,差异有统计学意义(P<0.01)。(3)API阳性组患儿FeNO水平与血EOS计数存在相关性,API阴性组及正常对照组FeNO水平与血EOS计数无相关性。(4)101例复发性喘息患儿中喘息次数3~4次者与喘息次数≥5次者FeNO均数值差异无统计学意义(P>0.05)。结论复发性喘息患儿不同喘息次数组FeNO均值之间差异无统计学意义,应结合患儿的病史、EOS、FeNO、API等综合预测婴幼儿的喘息发作。

Objective To analyze the correlation between the fractional exhaled nitric oxide(FeNO)levels and blood eosinophil (EOS) count and the frequency of wheeze in infants with recurrent wheezing. Methods From February 2015 to August 2016 in the General Hospital of Northern War Zone, outpatient department of Pediatrics treatment and hospitalization of age less than or equal to 3 year old children with recurrent wheezing, 101 cases were induded as the research object.On the basis of asthma predictive index(API)score were divided into API positive group(n=55)and API negative group(n= 46), according to the wheeze frequency of the two groups children were divided into 3~4 times wheezing groups and more than 5 times.Select 37 cases of healthy children as control group.The concentration of FeNO and blood EOS count are detected in all the children.The correlation between the three groups of children with FeNO concentration, the correlation between FeNO and blood EOS count, the correlation between the the frequency of wheeze and FeNO in experimental groups were analyzed. Results (1)API positive group mean FeNO(19.3±6.2)ppb was significantly higher than API negative group(7.7±2.9)ppb, there was no difference(P>0.05). API negative group mean FeNO(7.7±2.9)ppb is lower than the normal control group(9.5±2.0)ppb, there was no difference(P>0.05).(2)API positive group mean EOS count(124.7±1.6)×10^6/L is higher than API negative group(86.1±1.9)×10^6/L, there was significant difference(P<0.01);(3)There was a correlation between FeNO level and blood EOS count in API positive group, there was no correlation between FeNO level and blood EOS count in API negative group and control group.(4)No statistical differences were found in ≤4 times wheezing groups and more than 5 times of the mean FeNO. Conclusion There is no significant difference in the mean value of FeNO between different times of wheezing in children with recurrent wheezing.The combination of medical history, EOS, FeNO and API might be used to predict the wheezing episode of infants.